With the plethora of technology opportunities and options out there to attract and engage patients to participate in the healthcare process and services they receive, what and where are the potholes, speedbumps and other road hazards that can hamper journeys along the information superhighway?
Slickness versus substance
“With the expansion of technology solutions like this, physicians are faced with determining the right tech partner,” said Chris Martini, Chief Provider Officer, and President, Hospital Solutions, PatientPoint. “They need to ask if their tech solutions are the most effective at driving behavior change. This is critical because while integrating technology is the way forward, tech partners must demonstrate that their innovations improve outcomes such as increased dialogue, satisfaction and compliance.
“Because of this, practice leaders will need to ask not only about the tech, but about the content,” Martini insisted. “Flashy tech isn’t enough. It needs to be paired with engaging education in order to improve the healthcare experience for patients and enable physicians to be more efficient in their care. Patients want education and interactive technology to help improve the healthcare experience and improve health outcomes. But not all exam room programs are created equal. While having a TV in the waiting room was sufficient in the past for some providers, in 2017 we’ll see a shift to technology/education partners who can provide engaging education and measurable results. For example, PatientPoint studies have shown that specialized content improves clinical outcomes, such as a 10 to16 percent increase in adherence to preventive screenings.”
‘Big Brother’ fears
“During the early adopter stage, we learned that some staff had concerns about ‘being tracked by big brother,’” said Marnie Lange, Product Manager-Patient Flow Solutions, Intelligent InSites. “As the word spread about the advantages of location technology in giving back time to nurses and physicians and getting patients in and out of healthcare facilities more quickly and safely, these concerns have diminished. We have found that it is most beneficial when registration staff are well-versed in explaining to patients how the location badges help improve the experience. Once patients understand, they are intrigued and appreciative of this heightened attention to their safety and satisfaction.”
Physical plant concerns
“Challenges for a face-down [viewscreen] orientation setup are definitely found in the mounting and cooling systems,” said Ben Hardy, Product Manager, NEC Display Solutions. “Because this is a unique application, often times a unique mounting structure will be needed in order to accommodate. This is where working with a knowledgeable integration partner comes into play as they design and install project-based mounting solutions.
“It’s also important that the displays have active cooling mechanisms built into them, like NEC’s X651UHD screen,” Hardy added. “This ensures that the products are designed to intake cool air then exhaust the hot air – and you can imagine at greater heights, where lighting and physics are a factor, that this is very important. Finally, mounting in this type of orientation requires that the ambient temperature of the display must be less than 40 degrees Celsius, or normal operating temperature. In order for healthcare organizations to overcome these challenges and ensure a successful installation, proper research needs to be done to find out which display products offer these necessary features.”
“If the patient cannot easily and comfortably access a tablet, they simply will not use it,” said Cris Daugbjerg, Vice President of Development and Sales, GCX Corp. “We have replaced poor mounting solutions with better products that fit the room properly, and we immediately saw patient utilization of the software go up. Since these facilities can monitor this utilization rather easily, a small pilot program and even A/B testing of multiple hardware solutions can be revealing. Beyond the mounting solutions that GCX directly provides, we have seen that hospitals are currently favoring Windows tablets for their enterprise functionality. Investment in greater wireless network capacity is of course common as well, as it has value well beyond running mobile devices for patients.”
“The challenge with [our] technology is that the healthcare industry is vastly over-surveyed and over-evaluated, and adding another survey is not always an attractive option,” said healthcare architectural design expert Lorissa MacAllister, PhD, AIA, NCARB, LEED AP, President, Enviah. “Organizations need to understand that the CORE Report is not just another survey, but a tool that can be used to look at an entire system holistically and can be used as a guideline for future improvement projects. With the CORE Report, staff often become aware of quick fixes they can make in their environment. These quick successes can help improve morale and reduce stress. An example would include enhancing the staff break room to provide respite by offering social areas and quiet areas for staff who prefer different levels of noise.”
“Everyone from our hospital administration to our maintenance crew participated in the rollout, and many learned how to use the interactive patient engagement technology,” acknowledged Dr. Donald Lilly, MD, Associate Chief Medical Officer, Charleston Area Medical Center (CAMC). “Records of patients viewing the videos are tracked and eventually become part of their medical record. Patients are also asked to complete quizzes to assess comprehension of the videos. Executive leadership involvement is essential for clinical staff to embrace interactive patient education and engagement technology. Understanding the health literacy issues of the patient population is a key factor in recognizing the value of being able to better communicate important self-care information.”
Overlooking clinical champions
“We understand that clinical staff are extremely busy with tasks that take time away from the bedside,” said Matt Barker, Vice President, Marketing, TeleHealth Services. “Many nurses are overburdened with all the new technology being implemented for patient care at their hospitals. Introducing another technology tool can appear to be overwhelming, but patient engagement solutions can actually save time and automate processes that free nurses for other patient-centric tasks. Hospitals need to make sure nurses don’t think they are too busy to use the tools to help them educate their patients and improve workflow. Patient engagement systems streamline and automate manual processes and deliver education at the optimal point of care. To overcome organizational barriers, it is important to have support from the entire organization with champions like Dr. Don Lilly at Charleston Area Medical Center Health System.”
Six degrees of separation
Will Hinde, Senior Director, Healthcare Practice, West Monroe Partners, pointed to six key areas that pose problems. First is compliance. “Healthcare is heavily regulated,” Hinde said. Second is security. “HIPAA and cybersecurity breaches are top of mind, and if data is exfiltrated the financial penalties may be steep.” Third is information. “A payer or provider only has a portion of a patients’ healthcare data making it hard to deliver more value.” Fourth is adoption. “Patients are not used to leveraging technology for healthcare use.” Fifth is technology debt. “Healthcare organizations, like hospital systems and insurers, are typically not strong technology players, and implementing more innovative solutions is burdened with the legacy technology platforms most have in place.” Sixth is talent. “Healthcare organizations have to compete with Silicon Valley and healthcare incubators to recruit and retain expensive resources to develop these types of apps.”
Hinde offered six solutions. “Healthcare organizations may overcome these obstacles by: Focusing on value and solutions that steer clear of compliance and legal risk; ensuring any and all data necessary is secure and addressing security upfront in development; partnering with other healthcare organizations or finding a way to collect patient information as part of the app; investing in education, and making sure the app delivers value to the patient; setting up a sandbox for innovation and allowing mobile development to leverage the latest and greatest technologies; and hiring talent outside of industry, such as a Chief Customer Officer from a bank or retail company,” he said.
Take a holistic approach
Orbita strives to satisfy the needs of the various stakeholders involved with its review, deployment, and ultimate adoption, focusing on five key groups, according to Nathan Treloar, President and COO, Orbita Inc.
Patients: “Adherence is a universal challenge for any healthcare solution in which patients are engaged, in part or in whole, in their own care,” Treloar said. “Getting patients to adhere to a treatment requires techniques and technology that respect their interest and abilities.
“Orbita’s approach to address patient adoption and adherence is to enable flexible adoption of the right technology for the patient’s needs. For example, older patients with compromised vision, or simple technology phobias, can benefit from a more natural voice-powered care agent delivered through a platform like the Amazon Echo or Google Home, or even via a simple ‘smart button’ that the patient can push to notify their care circle that they need help, or that they took their medication. Voice solutions, in particular, provide a more complete wellness experience by engaging the patient not just with healthcare support, but with entertainment – for example, ‘play some Willie Nelson’ – and even cognitive touch points – ‘What day is it today?’ – that inform an overall sense of wellness.”
Family and Friend Caregivers: “For many individuals under home care, family members and sometimes close friends play a significant role in caregiving and medical decision-making. Collaboration and communication among these individuals and the patient ensures they are empowered to participate in the care of the loved one, and helps them in making more informed and timely decisions either collaboratively or on their behalf.”
Provider Administrators: “Incentives for healthcare systems to adopt more efficient and more effective home care solutions are coming mainly from new value-based programs that reward quality of care over quantity of care. If those financial incentives are not in place or not (yet) prioritized, getting these solutions into the organization will be very difficult and other incentives need to be pursued. Among them, things like patient loyalty or customer retention and market differentiation or new customer acquisition get attention from some healthcare providers. For example, some joint replacement clinics consider post-discharge care plans to not only improve care, but also to differentiate themselves from competitors by better reaching and engaging patients at home.”
Provider IT Administrators: “Information technology stakeholders within healthcare providers are suffering from ‘pilot fatigue.’ They have seen a myriad of hacked together home healthcare implementations that have failed to prove their value because of incompleteness, poor user experience, or lack of integration with internal systems, such as EHR. Pilots still have merit as a method to prove the potential of a solution, but provider IT administrators have become smart about evaluation of supporting technologies. More than just a throw-away mobile application, they are looking for robust platforms for connected home healthcare that are secure, flexible and can scale across the varying patient populations their organization serves.”
Clinicians: “Physicians, nurses, surgeons and other clinical care providers do not need more data and are certainly overloaded with alerts. As much as these professionals care about having insights into their patients’ wellness between visits, they are already drowning in a sea of data. Clinicians need less data and more actionable insights. Orbita provides clinicians with a way to target the most important data first, through intelligent data mining, predictive analytics, and dynamic monitoring.”